FHC NH Partnership for Patients Our charge is clear: reduce preventable harm by 40% and reduce preventable readmissions by 20% by 2013.

Partnership for Patients Launched in April 2011 Initiative from the Centers for Medicare & Medicaid Services Innovation Center Established by the Affordable Care Act to identify and develop promising new models of care delivery to reduce costs and increase quality. $500 million funding

Keep patients from getting injured or sicker. By the end of 2013, preventable hospital- acquired conditions would decrease by 40 percent compared to Achieving this goal would mean approximately 1.8 million fewer injuries to patients, with more than 60,000 lives saved over the next three years.

Help patients heal without complication. By the end of 2013, preventable complications during a transition from one care setting to another would be decreased so that hospital readmissions would be reduced by 20 percent compared to Achieving this goal would mean more than 1.6 million patients will recover from illness without suffering a preventable complication requiring re- hospitalization within 30 days of discharge.

Hospital Engagement Networks 26 State, regional and national hospital system organizations – help identify solutions already working to reduce healthcare acquired conditions – work to spread them to other hospitals and health care providers – develop learning collaboratives for hospitals – rapidly improve patient safety in hospitals Two “HENs” in NH – NH FHC Partnership for Patients – Intermountain Healthcare

NH Hospitals: 100% Engagement

Partnership for Patients: Core Areas of Focus Adverse drug events (ADE) Adverse drug events (ADE) Central line-associated blood stream infections (CLABSI) Central line-associated blood stream infections (CLABSI) Pressure ulcers Pressure ulcers Surgical site infections Surgical site infections Injuries from falls and immobility Injuries from falls and immobility Catheter-associated urinary tract infections (CAUTI) Catheter-associated urinary tract infections (CAUTI) Obstetrical adverse events Obstetrical adverse events Venous thromboembolism (VTE) Venous thromboembolism (VTE) Ventilator-associated pneumonia (VAP) Ventilator-associated pneumonia (VAP) Preventable readmissions Preventable readmissions

Building upon platform of NH Partnership to ELIMINATE HARM by 2015

Venous thromboembolism (VTE) Venous thromboembolism (VTE) 1 st Focus as part of NH Eliminate Harm by 2015 “VTE Prevention-Live Clot Free” in NH toolkit distributed July 2011 to all hospitals Data collection began Q4 2011: VTE prophylaxis and DVT/PE Incidence Varying degrees of implementation, some driven by Meaningful Use & SCIP

Live Clot Free in New Hampshire Toolkit sent to all hospitals in July – Measurement definitions – Reporting forms – Sample protocols – VTE discharge education sheet – FAQ

Summary of VTE Data Audit period: October 1 – December 31,2011 discharges 22 Hospitals submitted VTE Data Range of Eligible Patients audited per hospital was from 5 – 3230 patients – 1 less than 30 – 14 Hospitals provided requested sample size of 30 – 7 more than 30

Hospitals Reporting VTE Data Alice Peck Day Memorial Hospital Androscoggin Valley Hospital Catholic Medical Center Cheshire Medical Center Concord Hospital Dartmouth Hitchcock Medical Center Elliot Hospital Exeter Hospital Franklin Regional Hospital Frisbie Memorial Hospital Huggins Hospital Lakes Region General Hospital Littleton Regional Hospital Monadnock Community Hospital New London Hospital Parkland Medical Center Portsmouth Regional Hospital Southern NH Medical Center Speare Memorial Hospital Valley Regional Hospital Weeks Medical Center Wentworth Douglass Hospital

% of eligible patients who received VTE prophylaxis or have documentation why no VTE prophylaxis was given

# of Hospitals with patients with confirmed VTE out of Twenty Two Hospitals who submitted data

Summary of # of Patients with confirmed VTE and # of those Patients who received no VTE prophylaxis HARM

Questions for Discussion In Search of Data Collection Methods – What are the barriers / challenges? – Lessons learned? In Search of Better Processes – What did you learn as you were doing reviews? – Did you develop tools to enhance VTE prophylaxis? – Did you identify any templates of best practices?

FHC NH Partnership for Patients 2013 VISION “Live Free of Medical Error, and Don’t Die!”